Per Shri Narendra Kawde, Hon’ble Member This consumer complaint has been filed by the complainant alleging deficiency in service due to medical negligence on the part of the opponents, claiming compensation of `80 Lakhs with interest @ 12% p.a. 2. The salient facts giving rise to file this complaint are elaborately placed herein below as complainant was repeatedly required to be hospitalized and slapped with hefty hospital charges :- a) The complainant is a senior citizen admitted in the opponent No.1-Hospital for operation of C.A.B.G. on 19/09/2005. Said operation was carried out by a routine procedure by opponent No.2-Dr.Arun Mehra. However, on 28/09/2005 blood was found oozing out from the incision on the chest, therefore, complainant was again taken to Operation Theatre for re-suturing and said procedure went on from 09.00 to 01.00 p.m. on 01/10/2005. After having done re-suturing procedure, the complainant was shifted to I.C.U. Wife of the complainant noticed that the complainant’s left palm and fingers were burnt and therefore, one Dr.Jain was called for clinical inspection. Said doctor after examining the complainant concluded that the hand has got burnt probably during the suturing process. Opponent No.2-Dr.Arun Mehra examined the patient on next morning and found that the complainant’s burns had bubbled with blister and he managed to puncture all the blisters and after applying betadine, covered the hand with gauge dressing and stated that it is a minor issue and will be taken care of. Said opponent No.2 allegedly informed the relatives of the complainant that there was heater in the Operation Theater and the complainant’s hand must have touched during suturing process and since the complainant was under anesthesia, he did not notice while palm was burnt and assured that this will be alright within a day or two. Opponent No.2-Dr.Mehra punctured the new blister formed and after applying ointment, the wound had been covered with gauge bandage. Thereafter the complainant was discharged on 12/10/2005 and the complainant received hefty bill of `6,49,704/- as against initial C.A.B.G. bill of `3,50,000/-. b) The complainant lodged a complaint with opponent No.1 stating that it was purely on account of negligence of opponent Nos.1&2 and he had been traumatized and got incapacitated because of left hand surgery as fingers have been cut. He further contended that he had been a very successful diamond broker and expert in assortment of diamonds for last 40 years and for this purpose, use of both his hands for assortment of diamonds for holding in one hand and magnifying glass in the other hand for evaluating and sorting of diamonds, thereby incurring loss of regular income as a diamond broker and assortment expert. c) It is further the case of the complainant that opponent No.3-Dr.K.S. Goleria got him readmitted on 08/11/2005 and performed surgery on 09/11/2005 on the thumb and ring finger, thus, inviting to undergo the pangs of the pain skin patch as well as the pain of the wounded fingers. To the shock of the complainant, opponent No.3 amputated his middle and little finger above the first digit and he was informed that this had to be done due to gangrene. Second time, complainant got discharged on 30/11/2005. d) The complainant while still under trauma of the damage to his fingers, besides the loss of his business suffered due to the extended hospitalization managed to issue legal notice to opponent No.1 against the hefty bill which according to him was apparently on account of negligence of opponents. Thus, the complainant had suffered loss due to his one hand being incapacitated because of amputated fingers to attend his business and extended hospitalization for more than two months for complete recovery and also heavy expenses on account of medicine and frequent visits to the hospital. The complainant being a senior citizen and single bread earner faced the problem of his one hand being incapacitated to handle small diamonds during the assortment process. Finally, the complainant has come out with a prayer to issue directions to the opponents for their guilts of professional negligence and deficiency in service and prayed for compensation of `80 Lakhs in all. 3. All the opponents (opponent Nos.1to3) have vehemently denied the contentions of the complainant by filing written version (of opponent No.2 and affidavit) stating that the complainant is/was a patient with unstable angina, the condition which mandates hospital admission and urgent treatment as there was risk of myocardial infarction (heart attack) and even death. The complainant made a false statement about his earning and it was specifically stated that he was retired from the business and there was no source of income when admitted to Jaslok Hospital for anginal chest pain and therefore, he prayed for free of charges treatment in opponent No.1-Hospital after his admission. Opponent No.2 on listening this story, treated the complainant free of charge. C.A.B.G. operation was carried out with full written consent of the complainant with clear understanding given to him of any likelihood of major risks or complications of C.A.B.G. procedure including but not limited to infection, drug reaction, blood clots, bleeding, paralysis, loss of limb function, brain damage and loss of life with no guarantee of the outcome of the C.A.B.G. operation. The complainant-patient was having case history of long standing diabetic condition which finally led to Tropical Diabetic Hand Syndrome (T.D.H.S.). In the case of complainant it was a diabetic bullae to start with and later had T.D.H.S. and further explained in the written version what T.D.H.S. in any adult diabetic patient with hand cellulites, infection and gangrene. Patient with diabetic mellitus have impaired immunologic responses to combat infections. Infection and ulceration of the hand is a major cause of morbidity and mortality in such patient. 4. It is further stated in the written version that Breach Candy Hospital is equipped with warm air blowers which are used which cuts off automatically at 42˚C and denied the theory of complainant that his hand must have touched to heater, resulting into burning of his hand during re-suturing process. Even all such heaters are manufactured with safety net and it is not possible to touch heater coil under any circumstances by the patient. It is further stated that no heaters used in the Operation Theater or in the I.C.U. in the Breach Candy Hospital, only warm air blowers are fitted to warm the patients. All the opponents have totally denied the complainant’s theory of burning his left palm with heater in the Operation Theater and it is further stated that symptoms of heater burn and T.D.H.S. are similar and can be distinguished not clinically but by histopathological analysis and filed expert evidence to support their version to establish that T.D.H.S. result, into burn of the hand leading to gangrene and to prevent the same, skin grafting on the fingers was suggested to patient/complainant. 5. The complainant filed rejoinder alleging new theory of finger burnt to cautery burns. This contention of the complainant has been repudiated by opponent Nos.1&3 stating that cautery machines which are not in use in present time and to get such cautery burns are next to impossible as the cautery machines even if used have an inbuilt safety device which prevents any kind of burns from taking place. 6. We heard Mr.A.V. Patwardhan, Learned Advocate for the complainant and Dr.G.N. Shenoy, Authorised Representative for opponent Nos.1&3 and Mr.S.B. Prabhawalkar, Learned Advocate for opponent No.2. 7. Learned Advocate of the complainant submitted that C.A.B.G. i.e. open heart surgery, carried out by opponent No.2-Dr.Arun Mehra went on smoothly. The insurance claim under the medi-claim policy was settled in respect of expenses and there was no concealment of diabetes as issue raised now. The case of hand burning led to second time admission of the complainant when re-suturing the post C.A.B.G. operation was carried out as the blood was oozing out from the chest. Initially, it was presumed to be a case of heater burn of left palm in the Operation Theater itself as stated by opponent No.2. However, proper diagnosis of palm burning was not concluded. Therefore, the complainant forced to attribute the burning of palm to the cautery burns. Initially, there was no diagnosis of T.D.H.S. leading to amputation of the fingers at the time of admission. When heater was not in the Operation Theater, why fingers could have burnt and developed blisters. No treatment ever at the time of admission was given for T.D.H.S. and remarks of attending Dr.Kaushik are quite evident in the hospital record. No diabetes treatment was given except for the burn. The complainant-patient was required to be admitted on three different occasions, each time discharged with no satisfactory result. 8. Learned Advocate for opponent No.2 Mr.Prabhawalkar submitted that opponent No.2-Dr.Mehra had followed the international protocol of treatment and relied on the written version of opponent No.2 which is self explanatory and evident. As the patient was suffering from long standing diabetic condition which led to development of T.D.H.S. left hand palm was burn and the blisters were developed. The patient was taken care of by Dr.Kaushik, but the patient did not follow-up said doctor for further treatment as advised. Since the patient was with long standing diabetes history though C.A.B.G. operation was smoothly carried out uneventfully, but re-suturing was required due to diabetes history of the complainant-patient and therefore, opponent No.2 had to perform re-suturing post C.A.B.G. operation. Blisters in both the case of heater burns and effect of T.D.H.S. are similar and there is supporting expert evidence on record of Dr.Kaushik. Hystopathology diagnosis of the burns of the palm is on record and it is taken to be final diagnosis which is supported by the expert evidence of Dr.Goleria. Opponent No.2 has taken due care as required under the medical ethic and operated the complainant without taking any professional fees as the complainant initially pleaded that he was a retired person without any earning. Opponent No.2 has taken due care and on no occasion, there is lapse or negligence on the part of opponent No.2. On the contrary, opponent No.2 has extended all possible help to co-ordinate standard treatment to save the amputation of burned fingers of the complainant by referring the complainant-patient to Dr.Kaushik and Dr.Goleria i.e. opponent No.3 who very prompted monitored the progress on day-to-day basis. 9. Learned Authorised Representative Dr.Shenoy of opponent Nos.1&3 pleaded that timely measures were promptly initiated for removal of phalanges as the complainant developed gangrene in the left hand palm and not amputated the fingers of the complainant-patient as alleged in the complaint. The fingers are very much present and insisted upon to refer to an affidavit of plastic surgeon i.e. opponent No.2-Dr.K.S. Goleria. Dr.Goleria is a well known Plastic Surgeon, who followed approved protocol of treating burns due to gangrene and no deficiency was shown in treating the complainant-patient. Management of T.D.H.S. is not different from management of burnt hand. The theory of ‘cautery burnt’ had first time referred to by the complainant in rejoinder which was never averred or stated at any point of time well before that. The cause of gangrene is insufficient blood supply to the affected part which caused because of “endarteritis – a known sequelae in long standing diabetic case of complainant”. Complainant’s fingers as alleged had never been amputated. However, the terminal phalanges had to be removed due to development of gangrene as the complainant-patient was a long standing diabetes. No stone was left unturned by opponent No.3-Dr.Goleria for treating the burnt hand of the complainant and supporting expert evidence by way of affidavit of Dr.V.H. Vahia is available on record. 10. Further it was submitted that the complainant had history of alcohol and he was treated for psychiatric problem and there is expert affidavit on record of Dr.Vahia, Psychiatrist. As regards hystopathology report which is considered as final in respect of burnt fingers to refer to the cause of gangrene due to T.D.H.S., there is expert evidence of Dr.Suvin Shetty, a Pathologist supporting this contention. Histopathology Report clearly indicates that it was a case of burnt and not a cautery burns as nothing has happened in the Operation Theater. There is another expert opinion of Dr.H.B. Chandalia, Diabetologist stating that T.D.H.S. could be a mistaken for burns as both of them appear similar and moreover, treatment of T.D.H.S. is identical to that of burns with the addition of Insulin. Therefore, claim of the complainant that he was suffering from heater burns and not gangrene due to prolong diabetes is misconceived. The complainant suffered deformity to the extent of 2% for the middle finger and 3% for little finger as per expert opinion of Dr.V.J. Laheri, who is Head of Department of Orthopedic Surgery at KEM Hospital and not total deformity as alleged in the left hand fingers. 11. We have perused the record and documents tendered by the parties. There is no denial of the fact that complainant-patient was admitted with opponent No.1 and first time operated for C.A.B.G. by opponent No.2-Dr.Arun Mehra attached to opponent No.1-Hospital. There is also no denial of the fact that the complainant was again operated for re-suturing (post C.A.B.G.) operation by opponent No.2 as blood was oozing out from original sutures. The record reveals that complainant was long standing diabetes and he was under treatment for the same. Prior to operation of C.A.B.G., opponent No.2-Dr.Mehra given prescription for diabetes contrary to the submissions of Learned Advocate for the complainant. The case of cautery burn was made out first time in the rejoinder by the complainant, which could not be established by adducing documentary evidence by the complainant. The submission of Learned Advocate for the complainant that T.D.H.S. theory was never diagnosed initially is not acceptable in as much as there is abundant material placed on record to establish that complainant developed T.D.H.S. leading to gangrene affecting foot or hand with documentary evidence by tendering affidavits of experts in the field. In the burn case due to gangrene and heater burns are having identical symptoms with the blisters and they are treated accordingly on the lines of burns same with addition of insulin is proved by the opponents by adducing documentary evidence of the experts supported by medical literature. The complainant did not follow up with Dr.Kaushik though he was advised to do so for treatment of finger burns as it evident from record. 12. The complainant though averred that he is a bread earner of the family as a diamond broker, made a statement at the time of admission in the Jaslok hospital for unstable angina that he is a retired person without any income. Therefore, contention of the complainant that he has lost business due to alleged amputation of left hand fingers (which is not) is unacceptable. Opponent No.2-Dr.Arun Mehra and opponent No.3-Dr.K.S. Goleria, as the record shows treated the complainant-patient as per the standard protocol of treatment laid down and therefore, allegation of negligence on their part as tried to be made out by the complainant are not proved. Hefty bill of `6,49,704/- which was issued by the hospital authorities annoyed the complainant as his request was turned down to reconsider his billed amount and ultimately resulted into filing of this consumer complaint. Operation of the fingers for terminal phalange was required due to gangrene. As alleged fingers of the complainant-patient were never amputated as per the expert opinion of Dr.Laheri and only 2% for the ring finger and 3% for the middle finger, deformity had occurred due to removal of terminal phalange from the affected fingers as submitted by Authorised Representative of opponent Nos.1&3. Opponent No.2-Dr.Arun Mehra has specifically denied on oath averment of the complainant or his relatives about burn of hand fingers by heater in the Operation Theatre. In absence of rebuttal evidence on record from the complainant, ‘heater burn’ theory cannot be established. Complainant did not lead any cogent evidence to bring forth ‘negligency’ of opponent No.1-hospital authorities. 13. Hospital case paper record of the complainant and documentary evidence placed on record by the opponents lead us to conclude that opponents have exercised due care and caution to treat and operate the complainant-patient on two occasion i.e. for C.A.B.G.(Open Heart Surgery) and for removal of terminal phalange of the burn fingers without amputating the fingers of hand of the complainant. The complainant failed to establish negligence of the opponents for treating him as inpatient in the opponent No.1-Hospital and further, could not make out case of deficiency of service against all the opponents. Complaint is therefore devoid of merit. In the circumstances, we proceed to pass the following order:- -: ORDER :- 1. Complaint stands dismissed. 2. In the given circumstances, parties to bear their own costs. 3. Copies of the order be furnished to the parties. Pronounced Dated 28th March 2012. | 
